- Elevance Health (Louisville, KY)
- **Internal Auditor Senior - SOX & SOC1** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... an accommodation is granted as required by law. The **Internal Auditor Senior** is responsible for responsible for conducting financial/operational audits, internal… more
- Elevance Health (Louisville, KY)
- **Internal Auditor , Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law. The **Internal Auditor , Senior** is responsible for conducting financial/operationalaudits, internal control… more
- Elevance Health (Louisville, KY)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate… more
- Elevance Health (Louisville, KY)
- …Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- Elevance Health (Louisville, KY)
- …and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately ... formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The Clinical Provider Auditor II is responsible… more
- Datavant (Frankfort, KY)
- …vision for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded ... a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in...CIC or CRC) + A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease… more
- Highmark Health (Frankfort, KY)
- …all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of ... Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding… more
- Datavant (Frankfort, KY)
- …healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring ... across Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes. + Ability to… more
- Humana (Frankfort, KY)
- … Medical Coding Professional extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more
- CVS Health (Frankfort, KY)
- …Summary** + Responsible for performing second level quality inter-rater review audits of medical records coded by internal team, as well as external vendor ... guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify and communicate documentation deficiencies to allow… more